Long overdue

It's time to negotiate with the Obama administration on expanding Medicaid.

Copyright 2013: Houston Chronicle

Updated 7:03 pm, Wednesday, April 10, 2013

"Give up the swagger and get serious."

That's the best advice we've heard lately for Gov. Rick Perry. The Dear Abby in this case is U.S. Rep. Joaquin Castro, D-San Antonio. The first-term congressman urged the Texas governor to "negotiate in earnest with the Obama administration" on expanding Medicaid.

Perry, of course, was having no part of the unsolicited advice, as he made clear last week during a round-table discussion with U.S. Sens. John Cornyn and Ted Cruz and other like-minded Republicans who continue to reject expanding the state's Medicaid program under the Affordable Care Act.

Perry and friends are unmoved by the fact that the federal government will send Texas $100 billion during the next decade to pay for covering more working-poor Texans who are uninsured. The state would have to invest approximately $15 billion.

They're unmoved by the fact that the Lone Star State leads the nation in the number of residents without health care (24 percent) or that business groups, hospital officials and local officials - including Harris County Judge Ed Emmett - are urging the governor to acknowledge the fact that Medicaid expansion would provide more efficient care and lower costs to local property taxpayers.

The governor continues to repeat the mantra that Medicaid is a "broken system" that will break the state budget if it's expanded. Texas doesn't need another mandate, he insists.

Never mind that Medicaid expansion could offset $1.2 billion in the 2014-15 budget that Texas would spend on other health programs to cover poor populations, according to a recent report by Billy Hamilton, the state's former budget estimator.

Fortunately, the state has a number of elected officials, Republicans and Democrats, who are more serious about addressing the needs of their fellow Texans and less concerned with scoring political points against the president and his despised Obamacare. They include state Rep. Garnet Coleman, D-Houston. The House veteran, an expert on health policy, still believes a deal can be worked out between Washington and Austin.

"Negotiations have to start someplace, and he's picked his starting position," Coleman said, referring to Perry. "I'm reading in between the lines."

Coleman is aware that, between the lines - or, more precisely, between the rhetoric - Texas and the Obama administration could negotiate a "Texas solution," as Lt. Gov. David Dewhurst termed it last week. The administration already has negotiated deals with other recalcitrant states, including Arkansas and Arizona.

State Rep. Joe Picket, D-El Paso, told the El Paso Times this week that something similar could be in the works for Texas, but only after the legislative session ends on May 27. That would allow expansion opponents to blame the bureaucrats, Picket said.